Peter Nicholas Jimenez, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

48471 Issued in CA

Practice address

31646 Dunlap Blvd
Suite #C
Yucaipa, CA 92399-1602

Phone

(909) 794-4909

Fax

(909) 794-4904

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peter N Jimenez DDS a Professional Dental Corporation

  • Pediatric Dentistry
  • Yucaipa, CA
  • NPI 1598232308
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891828778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31646 DUNLAP BLVD",
            "address_2": "STE.C",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923991602",
            "telephone_number": "909-794-4909",
            "fax_number": "909-794-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31646 DUNLAP BLVD",
            "address_2": "SUITE #C",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923991602",
            "telephone_number": "909-794-4909",
            "fax_number": "909-794-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "PETER",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "48471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasleen Singh MD Professional
• Jeff T. Grange, MD
• Brett David Jeffries, PHARMD
• James Kevin Jetton, DDS
• Kristina Jimenez, LVN
• Mustapha John
• Dana Leah Johnson
• Mariah Johnson
• Michael A Johnson
• Neal Antonio Johnson, DDS

• Pediatric Dentistry in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.